Stories of COVID-19: Before and After
This week, we introduce our third and final Stories of COVID-19 series, which will be airing for six weeks. We’ve decided to begin this series in the same way that we started our original Stories of COVID-19 series back in November 2020 — with New York City nurse Harvey Katz.
Part 1: Harvey, a brand-new nurse, is thrust into the hectic environment of a Brooklyn ICU at the onset of the pandemic.
This story originally aired in November 2020, in the debut episode of our first Stories of COVID-19 series.
Part 2: In spring 2021, New York City nurse Harvey Katz begins to reckon with the trauma he’s experienced in the past year.
Harvey Katz is a nurse living and working in Brooklyn, NY and one of the hosts and creators of Take Two Storytelling - a monthly storytelling show and podcast.
Episode Transcript
Part 1: Harvey Katz
March feels like a million years ago and not because time flies but because time is a social construct and my social distancing game is like super strong these days.
Like four billion years ago in early March, we had our first and maybe our last ever family vacation. We went to Disney World. We touched handrails. We stood in long lines of crowds that collectively sighed in long exhales. Their hot breath on my neck was like a nice breeze. We didn't know that ‘it's a small world’ was a factual statement and not just the mutterings of animatronic optimists.
People kept talking about this virus in China and I thought they were all hypochondriacs. The flu, I kept saying. Worry about the flu.
I took a chill pill and ate a Pluto-themed veggie dog that passed through no less than seven hands before entering directly into my mouth. Hands. Hotdog. Mouth. That sounds ludicrous and straight up reckless now.
Less than two weeks later, I was pulling the acrylic nail off a woman who was gasping for breath. The oximeters can't get a good reading through the fake nails so I was in a near panic and using my own nails to pry off one of hers.
I'm a brand new nurse and this was two months into my employment at my very first nursing job straight out of nursing school, so I was, and I still am, living and dying by the numbers because, well, instinct is not instant, so that nail had to go.
She was also in liver failure which has this intoxifying effect on the body, so she kept ripping off this BiPAP mask that was pushing air into her wrecked lungs and then she was subsequently suffocating on repeat. Her oxygen monitors would alarm every 10 minutes or so and so I'd have to race into the room but not before I went through this arduous process of putting on my PPE.
And you could put on PPE a million times and it's still a clumsy process when you're in a rush. Your hands become these dumb, worthless blocks with performance anxiety while someone on the other side of a windowless door just slips into an oxygen-deprived blackout and hurries towards the light.
You have to resist the urge to just run into the room and start mouth‑to‑mouthing a stranger with a potentially deadly infection. The floor isn't lava but the air is. I kept thinking about people who are drowning whose panic ends up killing the person trying to save them, which in turn kills them both.
Alarm. Run. PPE. Re-oxygenate. Leave. Alarm. PPE. Over and over for hours. This was my first COVID patient. All I could think was, oh, my God. We are not prepared. This is not okay. We are not okay. There's no way I'm going to be able to do this day after day.
That morning was the last time I would kiss my wife for months. I wish I would have known that and I would have made it a kiss that could sustain us for a while, but it was just a have-a-good-day-I'll-come-home-and-kiss-you-later kiss. That night I slept on the living room floor. A few days later, I moved out of my house and into my friend's empty apartment.
My wife is immunocompromised but she's also my sounding board, my therapist, my person, my little spoon, the cutest of the cutlery. I've been leaning on her support extra hard recently because in the second, then the third, then the fourth opinion of my doctors I may or may not have cancer and the mystery was only going to be solved by a surgery booked for April 10th. It was daunting to think about going through this without her. It was heartbreaking to think about her going through this alone. I packed for a week not knowing I'd be gone for nearly three months.
Right after that patient with the fake nail, I got transferred to the ICU and I was a nurse there as the first wave of COVID grew and crested in New York City. We took care of the sickest patients in the hospital. It was the closest I would hope I will ever get to living in a sci-fi movie. Every patient had COVID. Every patient was being kept alive by machines, machines that fed the milky formulations and vasoconstrictors through their IV lines, machines that pushed air into their lungs, bags that collected less and less urine each day as their kidneys failed.
Patients were given a 20% chance of survival but I suspect that number was elevated. We wore PPE even in the hallways. Between the gowns and the goggles and the masks it was hot and disorienting. Every shift was like preparing for a wrestling weigh-in. By the end of it, I had a raging headache and I couldn't stand up without spinning.
There's this level of intimacy between a patient in the ICU and a nurse that's unreproducible in any other part of my life. They're totally and completely dependent on you. You know more about their bodies than their mama. You know more about their bodies than they do. You know more about their bodies than you know about your own body.
And there were no visitors allowed in the hospital at this time so I made sure that I spoke to them extra kindly even though they were sedated because you never know what might get through. And I always took a minute to hold their hands and tell them they hadn't been abandoned. Like I said, I'm a new nurse. Better at caring than curing at this point in my career and my love language has always been access service.
At this point in the COVID story, caring was about all we could do, but every interaction, every act of service with the patient put us at great risk and was discouraged by my superiors.
At this point in the COVID story, caring was about all we could do, but every action, every act of service with the patient would put us at great risk and was discouraged by my superiors. So I would sneak into the rooms under the guise of fixing an IV and I'd rearrange their swollen limbs and linger there for just an extra minute with my hand on their forearms. I did it for the both of us. There was no other human touch at this time for me other than that between me and my patients.
Even between the healthcare workers, there was no high fives, no hugs. All facial expressions were hidden behind masks. It was bizarre and cold. I felt the need to connect to my patients, to reconfirm that this was all real.
Beyond the physical acts of tending to their body as it lived on separated from their consciousness, there's a pact we make to fight for them while they can't advocate for themselves, and to know and respect when their battle is over.
You use IV drips, fentanyl and propofol in pursuit of this painless amnesia. It’s the least you can do. You watch their vital signs for any signal that the fog is thinning and they become alert to the true terror of their situation because what COVID does to a body can be horrific and most people just want to die in their sleep. And every one of my patients died.
One of them was actively dying for hours. I watched him from the other side of the glass door riding the line between here and gone. He wouldn't let go until I went into his room and I held his hand, and then it happened really quickly. I wish them all well on their journey. Before I zipped up the body bags, I'd send them off with a safe travels, because who knows what happens after the here and now.
Newscasters were comparing COVID to a war. The hospital even gave us these stars from retired US flags. War's not my jam but the metaphor was fitting. I remember accounts from injured soldiers bawling over missing limbs, not because they were mourning their loss but because it meant they couldn't return to the battlefield and their platoon would have to go on without them while they were left in the dark on the sidelines with all their feelings and without all that consuming distraction of survival. Seemed crazy to me then but I came to identify my fear of getting sick whether from COVID or cancer as largely a fear of abandoning my post and it didn't seem so crazy anymore.
When you wear all that PPE, you're no longer identifiable as an individual. People can barely see your face and your badge is covered, so you're recognizable only as a team member, a soldier, if you will, totally de-individualized.
But outside the hospital I became hyper individualized as the gap between what I was experiencing expanded exponentially from what my friends were going through while they sheltered in place. Their version of the monster was loud and big. Its destruction made headlines and caused economic collapse.
My version was this rhythmic beeping until it wasn't and then it was just quiet. I visited my monster daily and day by day it told me more about itself. My monster lays silently on surfaces until everything I owned became ours together.
It's impossible to unsee what I saw with COVID. A couple weeks into it, I found myself ragged with the repeated trauma and I found it difficult to connect to anybody but my fellow healthcare workers. But I couldn't live in this bubble alone because outside of the hospital things were going badly.
During this time, my dad fell off a ladder and broke his pelvis. An elderly relative I care for fell and I left one shift one night to a voicemail saying she was in the emergency room. My wife was grieving the loss of our touch. And my doctor cancelled my surgery, that surgery that would determine whether or not I had cancer, a disease that killed my mom and was now smoldering in the plasma of my dad, a fact I ironically found out in March at Disney, the happiest place on earth.
The stress of not knowing was taking me to a level of distress I hadn't visited in my 40 years. Fortunately, the height of COVID in New York City was a pretty good time to be a nurse. Almost nobody said no to you. Your likeness was marketed as heroic, and any commercial that didn't feature a nurse was just a barbaric symbol of capitalism. Nurses, we could sell a Subaru to a Subaru salesman. That is to say we had some pull.
So towards the end of April I called my doctor and I pleaded for her to please, please do my surgery as soon as possible. And because I was a nurse a.k.a. a hero without a cape, she made special accommodations for me and was able to set up my surgery within that week.
I was almost looking forward to it. That week had been my worst one yet. In my straw that broke the camel's back moment, that elderly relative who I cared for dismissed my pleas for her to be careful saying, “There are worse ways to die.” Then I flew into a rage challenging her to name one, and then at that very moment I realized the level of trauma I had been experiencing.
That night I took a paper cup filled with whiskey to Walgreens, drank it all, outstretched my arm into a shelf of their seasonal goods aisle and emptied the entirety of their 70%-off Easter candy selection into my cart. That night, I drank Cadbury mini eggs straight from the carton in what I now refer to as my Fiona Gallagher total breakdown moment.
And you know you're having a shitty go at it when surgery is the highlight of your month, but I think I just needed to be cared for. I needed to be the patient. I needed someone to take on all the tasks of being in a body for a few hours so I could just sleep off the reality of being a human at this time.
Just before I was being led to the operating room, I asked to use the bathroom one more time and the doctor said, “I mean, we're going to put a catheter in you, so go if you'd like to but no need to do it on our behalf.” And instead of being horrified, it just sounded like luxury. Imagine that. They even pee for you in this place.
Laying on the operating table with my arms tied down and useless, a nurse rubbed my head so kindly. Touch, touch, touch. The anesthesiologist told me his plan. Fentanyl then propofol, just like what I gave my patients. The promise of analgesia and the gift of amnesia.
More people entered the room. The surgical team had at least eight people in it. I knew in just a matter of minutes I'd be naked and manipulated and entered and I'd be observed in a manner that in any other day would have me nauseous with the humiliation and shame, but butted up against the loneliness and fear I felt over the last month, it just felt so nice that so many people cared. And then I was asleep.
Waking from surgery is like crawling through a sweet, soft marshmallow then realizing it's in a fire. The nurse asked me if I was in pain and then pushed those magical opiates into my veins. The doctor told me all went well and that she was 90%sure I didn't have cancer and I could leave whenever I was ready.
I didn't know how to tell her I didn't want to leave this place where human touch still existed and they take away your pain and they tell you they're 90% sure you're going to be okay.
Part 2: Harvey Katz
When I tell my wife that I'm a stone-cold therapy top who has manipulated every therapist into changing the subject when it gets real, she is rightfully unimpressed. But like I warned them of my powers and still I have changed the subject from my dead mom to local politics quicker than you can say counterproductive on more than one occasion. It's not good for me, like I'm going to therapy because I need it. I've got this problem. I can't cry. I don't cry. I haven't done it in decades. I can't reach those low, low feelings. And I also can't feel the high feelings. I live in this muted palette of like beige to periwinkle. You know, my emotional experience is just so limited. And, you know, like when my friends are feeling like high moments of joy and I'm with them or we're having like a shared moment of grief, one of two things inevitably happens to me. Either I have this very visceral feeling of like a garage door just sort of closing me in and locking me out of the moment, or I'm literally locked out of my body, like I leave my body and I can't return to it to, you know, join in this moment with people.
And because I can't be present in it and I don't form a memory of it, it's like I just never was there. And I've even asked therapists like, you know, am I a sociopath, am I autistic, and they say, "No, you know, you just have a tendency to disassociate," and that felt too light for me. So I consulted the world's most powerful doctor, Google doc, and I did a Web search, you know, for like why I can't cry, all these like really sad Web searches. And I came up with like the Web self-diagnosis of depersonalization disorder. And I thought, like, how do I turn this into a good thing, right? So in my interview for my first nursing job, I figured I would get the question like, "why do you think you're a good fit for the emergency room?" And I would say something like, "Well, I'm very calm in moments, like in highly emotional moments." And they would hire me on the spot, but they didn't ask the question. But they did hire me. And I got my first nursing job straight out of nursing school as my dream job as emergency room nurse. And starting in January 2020, which we all can agree was the moment just before it all hit the fan in New York City.
And the way it works at this hospital is that you you don't go straight to the emergency room because that would be crazy for a new nurse. They train you a little bit in inpatient care. And I started at a regular inpatient unit. And they do things at something called primary nursing, which is that they try to assign the same patients to the same nurses as often as possible, because you really get to know that patient. You can really do a nice you know... You can treat them like... You know, continuity of care. They get treated better. And I had this one guy that I'd been working with for like a month, and he was cranky, but we really got to like each other in the end. And one day I come into work and his door is shut and there's a sign now on his door indicating that he's a COVID rule-out case. And I just thought like, "No way, not this dude." You know, I'd been working with him for so long. But I didn't really have time to think about it, because like ten minutes into the shift, his oxygen levels drop. He codes really fast. He's in full cardiac arrest. And this is mid-March. We have like no PPE in the hospital. And so they were really limiting the amount of people inside the code.
So it was just, they just picked me, worst option ever. And a new doctor who also didn't know anything. It was just like we were just totally out of our depth, you know, and I'm in there and I'm like pumping his chest and there's doctors outside the door and they're yelling at us of what to do or go faster, pump faster, getting this med. It was the worst relay race. I was like running to get a med and coming back to push it. Like CPR is so violent on a body, and this guy just he really had a very, very poor prognosis even before he died this time. And so they did the really kind thing, which is that they sort of ended the code a little bit earlier than they would in a normal situation. And then it was, you know, like when you were doing CPR, like I'm in this moment of like incredible adrenaline pumping. You've got this stinky stress sweats, you know, like everything is going slow motion and a million miles at the same time, the monitors are alarming. The most alarming alarm sounds that are just panic inducing. And then it's over and all of a sudden there's nothing. And in this moment between like extreme action and no action at all, I felt it, like there was this tightness in my throat. And I felt the swell rising in my body and I thought, "Oh, my God, it's going to happen, like I'm going to cry."
And I just thought like three, or maybe more, therapists have like tried to take me to this precipice and failed, and here I was like king of Cry Mountain. And I was like, "All right, keep it cool," and I was like, "Excuse me." And I walked to the storage room and I steadied myself and I tried to like relax the borders of my body so they would stretch against my body trying to leave itself. And just as the cry was just fixing to breach the surface, the charge nurse comes in. Crytus interruptus. I lost the moment. It all dissolved and went away. I lost my opportunity.
But like a week later, I was transferred to ICU to do my training there and there it was like hospice in space. You know, everybody wearing spacesuits. Everybody was dying of COVID at that time. You know, there was like tubes bringing oxygen and nutrients to people, bags collecting body waste. It was all just very horrible and strange. And there was like nothing we could do for these patients, even though there was so much we wanted to do. And so some days there just wasn't like a lot of action, and one day, my job, I came in and the charge nurse said, like, "Your job today is to watch this person die.
They had a DNR. They were already actively dying. They needed somebody to sort of mark the time of death. And then I guess I would get something else to do that day. So I just stood there, you know, and I watched through the glass and the numbers just got worse and worse, and it happens kind of slowly, then it pauses, and slowly, then pauses, and then all of a sudden it was just dead. I marked the time of death. Cleaned up his body, prepared him for transport to the morgue, and the whole time, I just like, I just felt nothing, you know. I was just there doing a job. And a doctor who had been working alongside me, you know, taking care of this patient for the last couple of weeks, came up, and he was kind of shaken by the death. He said, you know, "Are you OK?" And I was like, "Oh, yeah, no problem." And like I knew immediately, I messed up. You know, it was like I had just shared a part of myself that I didn't mean to share to him and he found out that I was this like robot not-person, like this impostor of a human. And now I was really embarrassed that my secret was out at work, that I didn't have the skill set to be a human.
And so, you know, and I think of crying as a tool, a tool of being human. You know, it's controlled by our autonomic nervous system. It's a part of our body we have no control over. It's the part of our body that, you know, makes us blush when we have a crush. It makes our heart race faster when we're scared. Evolutionary scientists theorize that crying is this auditory and visual signal to other people that we're in pain and that we need help. Tears, they have this protein in them and it makes it so they cling -- this is like the sweetest thing -- it makes it so they cling to your cheek just a little bit longer so that this like S.O.S. message to other people would just like stick around and more people can get it. You know, I just think that's the sweetest thing. But, you know, crying, it just does a lot of the talking for you. It's sort of like I think of it as like that TikTok trend that's like, "tell me you're in pain and need help without telling me you're in pain and need help." It really works.
And, you know, without this skill, without this like tool or this decompression method, as the pandemic went on, I went into full on disassociation mode. Like I would imagine myself walking beside myself in this world. And I thought like maybe this other me will just like taking an un-agreed-upon turn and wander off. And that'll be that. I don't even know if I cared anymore, you know.
And then Erin Barker called me and said, "Would you do a story for us for our series on COVID?" And I was like, "Yeah, of course." And I spent the next month sort of like weaving together this patchwork of all these experiences I had and trying to find the line that made this, you know, nice emotional arc for the story, as one does. When you can't cry, you have to use your words. And when you retell, you have to relive. And when you're writing your story, you're putting your story together, you have to sort of... It's an exercise in being present. You know, sure, you're present in the past, but you have to stay still in that moment long enough to create the sensory snapshot that you can share with other people. And interestingly enough, meditation, according to the Internet, is one of the treatments used for people with depersonalization disorder. Now, story listening, on the other hand, that's a crapshoot, you know. I think of it as like taking a pill that some rando handed you in a club and you don't know if it's going to be an upper or a downer until
it's like you cannot reverse course at that point. And so when this story came out, I just didn't know how I was going to feel when I listened to it. And it took me a while and then I did listen to it and then I listened to it again. I listened to it again, and then I found myself just kind of listening to it all the time, like I would just be in the Trader Joe's listening to my story or riding my bike home, listening to my story. And I just needed it to remind myself that, like, what I went through was real and try to find a moment of connection, because the whole thing, you know, just was all very bizarre to live through, I mean, for all of us this last year.
I've had a few surgeries and I've read surgical notes, and you can't believe like all the ways that your body is torn through and and wounded and manipulated and you just have no connection to it. Like you just remember the time before and the time after and you think, "how could I have gone through such trauma and have not felt anything?" And listening to my story was like reading those surgical notes, like it gave me a moment to connect to what happened and understand the location and the mechanism behind the trauma and give me sort of like a path to understanding how to properly monitor these wounds for healing.
And I think that's... I don't know, today, the story, I wanted it to be an ode to the power of storytelling and how much healing listening to my own story did for me. When I had a patient... you know, when I have patients in the hospital, the first thing you do is you just ask them their story. Like you want to know, like "describe to me how you feel. And describe to me how you got to this point." And I just think, I'm just so grateful for the storytelling community and I mean, 11 years, so many stories, like all these people getting to think about how like the world relates to them and how other people's pain relates to them and how they can sort of manage their own pain and feeling so anyways, Story Collider, thank you so much. I had this whole thing planned, like going back to the therapy top thing that I can't remember now, how you're the top or I can top you. I wouldn't change you if I could. Something like that. Anyways, thanks, y'all.